Femoral prosthesis system

ABSTRACT

A provisional femoral component, in one embodiment, including at least one first visual indicator and at least one second visual indicator, the first and second visual indicators providing indicating means for simultaneously visually representing a first profile of a first femoral prosthesis and a second profile of a second femoral prosthesis. In another embodiment, a provisional femoral component including a patellofemoral flange having two sulci and a central ridge between the two sulci. In this manner, the provisional femoral component can be positioned on a resected distal femur surface of both a right and left knee joint.

BACKGROUND

1. Field of the Disclosure

The present disclosure relates generally to provisional orthopediccomponents used to replicate final orthopedic components during asurgical procedure. More particularly, the present disclosure relates toprovisional femoral components that assist in determining the propersize of final prosthetic components for replacement of all or part of anatural knee joint.

2. Description of the Related Art

Knee replacement provisional components are positioned on a distal femurand/or a proximal tibia to allow range of motion testing so that asurgeon can verify joint kinematics and/or proper sizing of finalprosthetic components. In certain surgical procedures, a surgeon mayremove and replace a provisional femoral component of a first size witha provisional femoral component of a second size to adjust the ligamenttension of the knee joint and/or to evaluate the M/L (medial/lateral)sizing of the provisional femoral component. For example, a firstprovisional femoral component having a first size can correspond to astandard sized femoral prosthesis and a second provisional femoralcomponent having a second size can correspond to a narrow sized femoralprosthesis. Such systems require a provisional femoral component foreach different sized femoral prosthesis. During knee surgery, a surgeonmay selectively remove and replace a provisional femoral component of afirst size with a provisional femoral component of a second size toadjust the ligament tension of the knee joint and/or to evaluate the M/Lsizing of the provisional femoral component and determine which femoralprosthesis should be selected for final implantation in a knee joint.

SUMMARY

The present disclosure provides a provisional femoral component which,in one embodiment, includes at least one first visual indicator and atleast one second visual indicator, the first and second visualindicators providing indicating means for simultaneously visuallyrepresenting a first profile of a first femoral prosthesis and a secondprofile of a second femoral prosthesis. In the system of the presentdisclosure, only one provisional femoral component is needed which cansimultaneously visually represent two different femoral prosthesisprofiles, as opposed to a system that requires a provisional femoralcomponent for each different sized femoral prosthesis. In anotherembodiment, the present disclosure provides a provisional femoralcomponent including a patellofemoral flange having two sulci and acentral ridge between the two sulci. In this manner, the provisionalfemoral component can be positioned on a resected distal femur surfaceof both a right and left knee joint. In the system of the presentdisclosure, only one provisional femoral component is needed which canbe positioned on a resected distal femur surface of both a right andleft knee joint, as opposed to a system that requires a left provisionalfemoral component for a left knee and a separate right provisionalfemoral component for a right knee.

The present disclosure, in one form thereof, comprises a femoralprosthesis system including a first femoral prosthesis including a firstcondyle defining a first articulating surface and an opposing first bonecontacting surface, and a first peripheral wall spanning the firstarticulating surface and the first bone contacting surface, the firstperipheral wall defining a first profile. The femoral prosthesis systemfurther includes a second femoral prosthesis including a second condyledefining a second articulating surface and an opposing second bonecontacting surface, and a second peripheral wall spanning the secondarticulating surface and the second bone contacting surface, the secondperipheral wall defining a second profile, wherein the second profile isdifferent than the first profile. The femoral prosthesis system furtherincludes a provisional femoral component including a provisional condyledefining a provisional articulating surface and an opposing provisionalbone contacting surface, a provisional peripheral wall spanning theprovisional articulating surface and the provisional bone contactingsurface, and at least one visual indicator and at least one secondvisual indicator spaced along the provisional peripheral wall, the atleast one first visual indicator visually representing the first profileof the first femoral prosthesis, and the at least one second visualindicator visually representing the second profile of the second femoralprosthesis.

The present disclosure, in another form thereof, comprises a provisionalfemoral component including a provisional condyle defining a provisionalarticulating surface sized and shaped to be engageable with a proximaltibia in joint articulating relationship and an opposing provisionalbone contacting surface sized and shaped to be engageable with a distalfemur, and indicating means for simultaneously visually representing twodifferent femoral prosthesis profiles.

The present disclosure, in a further form thereof, comprises a method ofdetermining a size of a femoral prosthesis for a prosthetic knee joint,the knee joint including a proximal tibia and a distal femur, the methodcomprising: obtaining a femoral prosthesis system including a firstfemoral prosthesis including a first condyle defining a firstarticulating surface and an opposing first bone contacting surface, anda first peripheral wall spanning the first articulating surface and thefirst bone contacting surface, the first peripheral wall defining afirst profile; a second femoral prosthesis including a second condyledefining a second articulating surface and an opposing second bonecontacting surface, and a second peripheral wall spanning the secondarticulating surface and the second bone contacting surface, the secondperipheral wall defining a second profile, wherein the second profile isdifferent than the first profile; and a provisional femoral componentincluding a provisional condyle defining a provisional articulatingsurface and an opposing provisional bone contacting surface, aprovisional peripheral wall spanning the provisional articulatingsurface and the provisional bone contacting surface, and at least onefirst visual indicator and at least one second visual indicator spacedalong the provisional peripheral wall, the at least one first visualindicator visually representing the first profile of first femoralprosthesis, and the at least one second visual indicator visuallyrepresenting the second profile of the second femoral prosthesis;positioning the provisional bone contacting surface of the provisionalfemoral component on a resected distal femur surface; and selecting oneof the first femoral prosthesis and the second femoral prosthesis forimplantation in the knee joint based on one of the at least one firstvisual indicator and the at least one second visual indicator.

The present disclosure, in another form thereof, comprises a provisionalfemoral component including a patellofemoral flange including a bonecontacting, non-articulating surface and an articulating surfaceopposite the bone contacting surface, the articulating surface includinga first sulcus formed in the patellofemoral flange, a second sulcusformed in the patellofemoral flange, a central ridge disposed betweenthe first sulcus and the second sulcus, the central ridge having a firstthickness, and a first anterior flange and a second anterior flangeextending along respective medial/lateral peripheries of thepatellofemoral flange, the first and second anterior flanges each havinga second thickness greater than the first thickness of the centralridge, the central ridge, the first sulcus, and the second sulcus eachdisposed between the first and second anterior flanges.

BRIEF DESCRIPTION OF THE DRAWINGS

The above-mentioned and other features and advantages of thisdisclosure, and the manner of attaining them, will become more apparentand the disclosure itself will be better understood by reference to thefollowing descriptions of embodiments of the disclosure taken inconjunction with the accompanying drawings, wherein:

FIG. 1 is a perspective view of a provisional femoral component inaccordance with an exemplary first embodiment of the present disclosure;

FIG. 2 is a front elevation view of the provisional femoral component ofFIG. 1;

FIG. 3 is a side elevation view of the provisional femoral component ofFIG. 1;

FIG. 4 is a cross-sectional view taken along line 4-4 of FIG. 3;

FIG. 5 is a perspective view of the provisional femoral component ofFIG. 1 positioned adjacent a resected surface of a distal femur;

FIG. 6 is a bottom elevation view of the provisional femoral componentof FIG. 1;

FIG. 7 is a perspective view of a knee joint illustrating a resecteddistal femur surface with a first femoral prosthesis having a firstprofile secured thereon and a resected proximal tibia surface with atibial bearing component and a tibial base plate attached thereon, andfurther schematically illustrating a second femoral prosthesis having asecond profile in dashed lines;

FIG. 8 is a perspective view of a provisional femoral component inaccordance with an exemplary second embodiment of the presentdisclosure;

FIG. 9 is a front elevation view of the provisional femoral component ofFIG. 8;

FIG. 10 is a side elevation view of the provisional femoral component ofFIG. 8;

FIG. 11 is an exploded perspective view of a provisional femoralcomponent in accordance with an exemplary third embodiment of thepresent disclosure and a modular insert component; and

FIG. 12 is an assembled view showing the modular insert component ofFIG. 11 attached to the provisional femoral component of FIG. 11.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate exemplary embodiments of the disclosure, and suchexemplifications are not to be construed as limiting the scope of thedisclosure in any manner.

DETAILED DESCRIPTION

The present disclosure, in one embodiment, provides a femoral prosthesissystem for determining the size of a femoral prosthesis for a prostheticknee joint, the femoral prosthesis system including a provisionalfemoral component including indicating means for simultaneously visuallyrepresenting two different femoral prosthesis profiles. FIG. 7illustrates a prosthetic knee joint, the knee joint including proximaltibia T and distal femur F. In the following discussion, “proximal”refers to a direction generally toward the heart of a patient, and“distal” refers to the opposite direction of proximal, i.e., away fromthe heart of a patient. As used herein, “anterior” refers to a directiongenerally toward the front of a patient, and “posterior” refers to theopposite direction of anterior, i.e., toward the back of a patient.Further, as used herein, “medial” refers to a direction generally towardthe middle of a patient, and “lateral” refers to the opposite directionof medial, i.e., toward the side of a patient.

The disclosed embodiments of the present disclosure include aprovisional femoral component. For example, provisional femoralcomponent 20A is shown in FIGS. 1-6 according to an exemplary firstembodiment, provisional femoral component 20B is shown in FIGS. 8-10according to an exemplary second embodiment, and provisional femoralcomponent 20C is shown in FIGS. 11 and 12 according to an exemplarythird embodiment. In FIGS. 1-6 and 8-12, reference numbers for theprovisional femoral components utilize the same numerical referencenumbers with different letters to distinguish the exemplary embodiments(i.e., provisional femoral components 20A, 20B, and 20C, respectivelycorrespond to the first, second, and third exemplary embodiments). Inthis manner, for the purposes of this disclosure, a reference numeralfollowed by A-C corresponds to a similar feature between the exemplaryfirst through third embodiments, respectively.

The first exemplary embodiment, as illustrated in FIGS. 1-6, includesprovisional femoral component 20A generally including provisional bonecontacting surface 22A and opposing provisional articulating surface24A, each extending between anterior flange 26A and posterior side 28A.Provisional bone contacting surface 22A is adapted to position andlocate provisional femoral component 20A relative to a resected distalfemur surface such as resected distal femur surface 160 of distal femurF shown in FIG. 5. Provisional femoral component 20A also includes firstcondyle 30A and second condyle 32A, with an intercondylar fossa formedbetween condyles 30A, 32A. Provisional articulating surface 24A isdisposed generally opposite provisional bone contacting surface 22A, andis comprised of the exterior surfaces of first and second condyles 30A,32A as well as the exterior surface of anterior flange 26A. First andsecond condyles 30A, 32A each include posterior condyle portion 38A anddistal condyle portion 40A. Provisional femoral component 20A alsoincludes patellofemoral flange 34A. Provisional femoral component 20Aalso includes femoral cam 42A formed at posterior side 28A. Femoral cam42A spans first and second condyles 30A, 32A.

In a posterior stabilized femoral component, such as provisional femoralcomponent 20A, cam 42A cooperates with a spine (not shown) formed in atibial component, such as tibial bearing component 182 shown in FIG. 7,to guide or constrain motion within certain predefined boundaries.Posterior stabilized prostheses are appropriate where the posteriorcruciate ligament (PCL) is torn or otherwise damaged, or where the PCLis resected during surgery.

In the exemplary embodiments of FIGS. 1-3, 5, 6 and 8-12, provisionalfemoral components 20A, 20B, 20C are posterior stabilized femoralcomponents, though it is contemplated that other femoral components maybe utilized in accordance with the present disclosure such as femoralcomponents which cooperate to form a cruciate retaining prosthesis, forexample. Provisional femoral components 20A, 20B, 20C may also be madeavailable in a variety of shapes and sizes to accommodate a variety ofdiffering knee physiologies.

Referring to FIG. 3, provisional bone contacting surface 22A ofprovisional femoral component 20A is adapted to mate with a resectedarticular surface of a distal femur, such as resected distal femursurface 160 of distal femur F shown in FIG. 5, and includes anteriorfacet 44A, anterior chamfer facet 46A, distal facet 48A, posteriorchamfer facet 50A, and posterior facet 52A. Anterior facet 44A, anteriorchamfer facet 46A, distal facet 48A, posterior chamfer facet 50A, andposterior facet 52A correspond to the cuts made to a distal end of afemur, such as distal femur F shown in FIG. 5, to allow implantation ofa femoral prosthesis component, i.e., anterior cut 164, anterior chamfercut 166, distal cut 168, posterior chamfer cut 170, and posterior cut172 made in distal femur F to form resected distal femur surface 160 asshown in FIG. 5.

FIG. 7 illustrates first femoral prosthesis 120 and second femoralprosthesis 140 according to an exemplary embodiment of the presentdisclosure. First femoral prosthesis 120 generally includes first bonecontacting surface 122 and opposing first articulating surface 124, eachextending between first anterior flange 123 and first posterior side125. First bone contacting surface 122 is adapted to affix first femoralprosthesis 120 to a distal portion of femur F, such as with bone cementand/or porous bone-ingrowth material. First femoral prosthesis 120 alsoincludes a pair of first condyles 126, i.e., a medial condyle and alateral condyle, each including first posterior condyle 127 and firstdistal condyle 128. First articulating surface 124 is disposed generallyopposite first bone contacting surface 122, and is comprised of theexterior surfaces of first condyles 126 as well as the exterior surfaceof first anterior flange 123. First femoral prosthesis 120 also includesfirst peripheral wall 132 spanning first bone contacting surface 122 andfirst articulating surface 124. First peripheral wall 132 defines firstprofile 134.

Second femoral prosthesis 140 is illustrated in dashed lines in FIG. 7to indicate a second femoral prosthesis having second profile 154different than first profile 134 of first femoral prosthesis 120. In oneembodiment, as illustrated in FIG. 7, second profile 154 of secondfemoral prosthesis 140 is geometrically analogous to, but smaller than,first profile 134 of first femoral prosthesis 120. Second femoralprosthesis 140, similar to first femoral prosthesis 120, generallyincludes second bone contacting surface 142 and opposing secondarticulating surface 144, each extending between second anterior flange143 and second posterior side 145. Second bone contacting surface 142 isadapted to affix second femoral prosthesis 140 to a distal portion offemur F, such as with bone cement and/or porous bone-ingrowth material.Second femoral prosthesis 140 also includes a pair of second condyles146, i.e., a medial condyle and a lateral condyle, each including secondposterior condyle 147 and second distal condyle 148. Second articulatingsurface 144 is disposed generally opposite second bone contactingsurface 142, and is comprised of the exterior surfaces of secondcondyles 146 as well as the exterior surface of second anterior flange143. Second femoral prosthesis 140 also includes second peripheral wall152 spanning second bone contacting surface 142 and second articulatingsurface 144. Second peripheral wall 152 defines second profile 154. Inthe embodiment illustrated in FIG. 7, the only difference between secondfemoral prosthesis 140 and first femoral prosthesis 120 is that secondprofile 154 is smaller in a M/L dimension than first profile 134 offirst femoral prosthesis 120. For example, the M/L dimension of theanterior facet (e.g., FIG. 3, 44A) of first profile 134 of first femoralprosthesis 120 may be approximately 3.70-4.57 mm larger than the M/Ldimension of the anterior facet of second profile 154 of second femoralprosthesis 140. The M/L dimension of the anterior chamfer facet (e.g.,FIG. 3, 46A) of first profile 134 of first femoral prosthesis 120 may beapproximately 4.19-5.76 mm larger than the M/L dimension of the anteriorchamfer facet of second profile 154 of second femoral prosthesis 140.The M/L dimension of the distal facet (e.g., FIG. 3, 48A) of firstprofile 134 of first femoral prosthesis 120 may be approximately3.97-5.71 mm larger than the M/L dimension of the distal facet of secondprofile 154 of second femoral prosthesis 140. The M/L dimension of theposterior chamfer facet (e.g., FIG. 3, 50A) of first profile 134 offirst femoral prosthesis 120 may be approximately 4.01-6.00 mm largerthan the M/L dimension of the posterior chamfer facet of second profile154 of second femoral prosthesis 140. The M/L dimension of the posteriorfacet (e.g., FIG. 3, 52A) of first profile 134 of first femoralprosthesis 120 may be approximately 4.00-6.00 mm larger than the M/Ldimension of the posterior facet of second profile 154 of second femoralprosthesis 140. First femoral prosthesis 120 defining first profile 134could be a standard femoral prosthesis and second femoral prosthesis 140defining second profile 154 having a smaller M/L dimension than firstprofile 134 could be a narrow femoral prosthesis in accordance withfemoral prostheses described in U.S. Patent Application Publication No.2007/0260323, published Nov. 8, 2007, entitled “Distal Femoral KneeProstheses,” the entire disclosure of which is hereby expresslyincorporated herein by reference.

Second femoral prosthesis 140 and first femoral prosthesis 120 of thepresent disclosure may be constructed of any biocompatible ceramic ormetal, including, but not limited to, titanium, a titanium alloy, cobaltchromium, cobalt chromium molybdenum, porous tantalum, or a combinationof these materials, for example. Some or all of the non-articulatingportions of first femoral prosthesis 120 and second femoral prosthesis140 may include a highly porous biomaterial useful as a bone substituteand as cell and tissue receptive material. A highly porous biomaterialmay have a porosity as low as 55%, 65%, or 75% or as high as 80%, 85%,or 90%. An example of such a material is produced using TrabecularMetal™ technology generally available from Zimmer, Inc., of Warsaw, Ind.Trabecular Metal™ is a trademark of Zimmer, Inc. Such a material may beformed from a reticulated vitreous carbon foam substrate which isinfiltrated and coated with a biocompatible metal, such as tantalum, bya chemical vapor deposition (“CVD”) process in the manner disclosed indetail in U.S. Pat. No. 5,282,861 to Kaplan, the entire disclosure ofwhich is expressly incorporated herein by reference. In addition totantalum, other metals such as niobium, or alloys of tantalum andniobium with one another or with other metals may also be used.

Generally, the porous tantalum structure includes a large plurality ofligaments defining open spaces therebetween, with each ligamentgenerally including a carbon core covered by a thin film of metal suchas tantalum, for example. The open spaces between the ligaments form amatrix of continuous channels having no dead ends, such that growth ofcancellous bone through the porous tantalum structure is uninhibited.The porous tantalum may include up to 75%, 85%, or more void spacetherein. Thus, porous tantalum is a lightweight, strong porous structurewhich is substantially uniform and consistent in composition, andclosely resembles the structure of natural cancellous bone, therebyproviding a matrix into which cancellous bone may grow to providefixation of second femoral prosthesis 140 and first femoral prosthesis120 to the patient's bone.

The porous tantalum structure may be made in a variety of densities inorder to selectively tailor the structure for particular applications.In particular, as discussed in the above-incorporated U.S. Pat. No.5,282,861, the porous tantalum may be fabricated to virtually anydesired porosity and pore size, and can thus be matched with thesurrounding natural bone in order to provide an improved matrix for boneingrowth and mineralization.

Referring to FIG. 7, articulating surfaces 124, 144 of first and secondfemoral prostheses 120, 140 ride on bearing articular surfaces 184 oftibial bearing component 182. Tibial bearing component 182 is positionedon tibial base plate 180 and tibial base plate 180 is positioned onresected proximal tibia surface 179 of proximal tibia T.

Although in the exemplary embodiment of FIG. 7, first femoral prosthesis120 and second femoral prosthesis 140 are illustrated as bicondylarfemoral prostheses, i.e., a femoral prosthesis having a medial condyleand a lateral condyle, it is contemplated that other femoral prosthesesmay be utilized in accordance with the present disclosure such as aunicondylar femoral prosthesis for a unicondylar knee arthroplasty. Aunicondylar femoral prosthesis includes a single condyle having a distaland posterior condyle portion and may replace either a medial or lateralcompartment of a distal femur. Referring to FIGS. 1-3, 5, 6 and 8-10,although provisional femoral components 20A, 20B are also illustrated asbicondylar provisional femoral components, i.e., a provisional femoralcomponent having a first condyle and a second condyle, it iscontemplated that other provisional femoral components may be utilizedin accordance with the present disclosure such as a unicondylarprovisional femoral component for a unicondylar knee arthroplasty. Forexample, first femoral prostheses 120, 140 and provisional femoralcomponents 20A, 20B could be part of a unicondylar knee system inaccordance with the unicondylar knee system described in the “Zimmer®Unicompartmental High Flex Knee, Intramedullary, Spacer Block Option andExtramedullary Minimally Invasive Surgical Techniques” brochure,copyright 2004, 2005, 2009, published by Zimmer, Inc., the entiredisclosure of which is hereby expressly incorporated by referenceherein.

In the exemplary embodiments of FIGS. 1-3, 5, 6 and 8-12, provisionalfemoral components 20A, 20B, 20C each can be used with first femoralprosthesis 120 and second femoral prosthesis 140 to form a femoralprosthesis system of the present disclosure.

Referring to FIGS. 1-3 and 6, provisional femoral component 20A includesprovisional peripheral wall 53A spanning provisional articulatingsurface 24A and provisional bone contacting surface 22A. Provisionalperipheral wall 53A includes a plurality of visual indicators. Forexample, provisional peripheral wall 53A includes first visualindicators 54A and second visual indicators 58A spaced in an alternatingmanner along provisional peripheral wall 53A. First visual indicators54A and second visual indicators 58A provide indicating means forsimultaneously visually representing two different femoral prosthesisprofiles. First visual indicators 54A of provisional femoral component20A are formed as protrusions and include exterior peripheral walls 56Aspaced along provisional peripheral wall 53A. Second visual indicators58A of provisional femoral component 20A are formed as cutouts ornotches spaced along provisional peripheral wall 53A and disposedbetween first visual indicators 54A. Each notch includes an indicatorwall, i.e., notch interior wall 62A. First visual indicators 54A andsecond visual indicators 58A are each spaced along provisionalperipheral wall 53A and are each part of peripheral wall 53A. Aplurality of first visual indicators 54A cooperate to visually representa relatively larger or standard profile of a femoral prosthesis. Forexample, first visual indicators 54A cooperate to visually representfirst profile 134 of first femoral prosthesis 120 (FIG. 7). A pluralityof second visual indicators 58A cooperate to visually represent aprofile of a femoral prosthesis smaller in a M/L dimension than firstprofile 134 of first femoral prosthesis 120 (FIG. 7). For example,second visual indicators 58A cooperate to visually represent secondprofile 154 of second femoral prosthesis 140 (FIG. 7). In this manner,provisional femoral component 20A is nominally sized to represent arelatively larger profile of a femoral prosthesis, i.e., exteriorperipheral walls 56A of first visual indicators 54A cooperate tovisually represent a relatively larger profile and notch interior walls62A of second visual indicators 58A cooperate to visually represent arelatively smaller profile.

In one embodiment, one second visual indicator 58A, e.g., one notchincluding notch interior wall 62A, can be disposed on each facet, i.e.,one notch disposed on each of anterior facet 44A, anterior chamfer facet46A, distal facet 48A, posterior chamfer facet 50A, and posterior facet52A. In another embodiment, one second visual indicator 58A can bedisposed on respective medial/lateral peripheries on each facet, i.e.,anterior facet 44A, anterior chamfer facet 46A, distal facet 48A,posterior chamfer facet 50A, and posterior facet 52A. In anotherembodiment, as illustrated in FIGS. 1-3, two second visual indicators58A, i.e., two notches each including notch interior wall 62A, can bedisposed on respective medial/lateral peripheries of anterior facet 44A,and one second visual indicator 58A can be disposed on respectivemedial/lateral peripheries on each of anterior chamfer facet 46A, distalfacet 48A, posterior chamfer facet 50A, and posterior facet 52A. In someembodiments, second visual indicators 58A can be centralized on arespective facet. Second visual indicators 58A are disposed alongprovisional peripheral wall 53A so that the geometry between each notchinterior wall 62A can be effectively interpolated. In this manner,second visual indicators 58A cooperate to visually represent a profileof a femoral prosthesis smaller in a M/L dimension than first profile134 of first femoral prosthesis 120 (FIG. 7).

In another embodiment, referring to FIGS. 8-10, provisional femoralcomponent 20B includes provisional peripheral wall 53B spanningprovisional articulating surface 24B and provisional bone contactingsurface 22B. Provisional peripheral wall 53B includes a plurality ofvisual indicators. For example, provisional peripheral wall 53B includesfirst visual indicators 54B and second visual indicators 66B spaced inan alternating manner along provisional peripheral wall 53B. In thisembodiment, first visual indicators 54B are formed as notches andinclude interior peripheral walls 62B spaced along provisionalperipheral wall 53B and disposed between second visual indicators 66B.Second visual indicators 66B are formed as protrusions spaced alongprovisional peripheral wall 53B and disposed between first visualindicators 54B. Each protrusion includes an indicator wall, i.e.,protrusion exterior wall 70B. First visual indicators 54B and secondvisual indicators 66B are each spaced along provisional peripheral wall53B and are each part of peripheral wall 53B. A plurality of firstvisual indicators 54B cooperate to visually represent a relativelysmaller or narrow profile of a femoral prosthesis. For example, firstvisual indicators 54B cooperate to visually represent second profile 154of second femoral prosthesis 140 (FIG. 7). A plurality of second visualindicators 66B cooperates to visually represent a relatively larger orstandard profile of a femoral prosthesis. For example, second visualindicators 66B cooperate to visually represent first profile 134 offirst femoral prosthesis 120 (FIG. 7). In this manner, provisionalfemoral component 20B is nominally sized to represent a relativelysmaller profile of a femoral prosthesis, i.e., interior peripheral walls62B of first visual indicators 54B cooperate to visually represent arelatively smaller profile and protrusion exterior walls 70B of secondvisual indicators 66B cooperate to visually represent a relativelylarger profile. In both exemplary embodiments illustrated in FIGS. 1-3,6, and 8-10, the visual indicators include a respective alternatingarrangement of protrusions and notches.

In one embodiment, one second visual indicator 66B, e.g., one protrusionincluding protrusion exterior wall 70B, can be disposed on each facet,i.e., one protrusion disposed on each of anterior facet 44B, anteriorchamfer facet 46B, distal facet 48B, posterior chamfer facet 50B, andposterior facet 52B. In another embodiment, one second visual indicator66B can be disposed on respective medial/lateral peripheries on eachfacet, i.e., anterior facet 44B, anterior chamfer facet 46B, distalfacet 48B, posterior chamfer facet 50B, and posterior facet 52B. Inanother embodiment, as illustrated in FIGS. 8 and 9, four second visualindicators 66B, i.e., four protrusions each including protrusionexterior wall 70B, can be disposed along provisional peripheral wall 53Bof anterior facet 44B. In some embodiments, second visual indicators 66Bcan be centralized on a respective facet. Second visual indicators 66Bare disposed along provisional peripheral wall 53B so that the geometrybetween each protrusion exterior wall 70B can be effectivelyinterpolated. In this manner, second visual indicators 66B cooperate tovisually represent a profile of a femoral prosthesis larger in a M/Ldimension than second profile 154 of second femoral prosthesis 140 (FIG.7).

Referring to FIGS. 8, 9, 11 and 12, while provisional femoral components20B, 20C are shown with regard to a left provisional femoral componentfor a left knee configuration, it will be appreciated that the presentdisclosure is equally applicable to a right provisional femoralcomponent for a right knee configuration.

Referring to FIGS. 1-12, the use of a femoral prosthesis system of thepresent disclosure to determine a size of a femoral prosthesis for aprosthetic knee joint including proximal tibia T (FIG. 7) and distalfemur F (FIG. 7) will now be described. Referring to FIGS. 1, 7, 8 and11, a user such as a surgeon obtains a femoral prosthesis system inaccordance with the present disclosure, i.e., one of provisional femoralcomponents 20A, 20B, 20C, first femoral prosthesis 120, and secondfemoral prosthesis 140. Next, referring to FIG. 5, the surgeon canposition provisional bone contacting surface 22A of provisional femoralcomponent 20A, for example, on resected distal femur surface 160. Withprovisional femoral component 20A, or provisional femoral component 20B,20C, positioned on distal femur F, the surgeon can use first visualindicators 54A to visually represent first profile 134 of first femoralprosthesis 120 (FIG. 7) and second visual indicators 58A tosimultaneously visually represent second profile 154 of second femoralprosthesis 140 (FIG. 7). The surgeon can simultaneously use first visualindicators 54A and second visual indicators 58A to visually confirmwhich are most properly aligned with perimeter 162 (FIG. 5) of resecteddistal femur surface 160 (FIG. 5), i.e., the perimeter of each ofanterior cut 164, anterior chamfer cut 166, distal cut 168, posteriorchamfer cut 170, and posterior cut 172. In one embodiment, the surgeoncan use first visual indicators 54A and second visual indicators 58A tovisually lateralize provisional femoral component 20A with distal femurF. For example, referring to FIG. 5, if distal femur F is a left knee,the surgeon can reference anterior left lateral portion 85A ofprovisional femoral component 20A with anterior lateral edge 173 ofdistal femur F. In this manner, the surgeon can determine if a standardfemoral prosthesis or a narrow femoral prosthesis should be implanted inthe knee joint based on which of first visual indicators 54A and secondvisual indicators 58A in anterior left lateral portion 85A ofprovisional femoral component 20A are more aligned with anterior lateraledge 173 of distal femur F. The surgeon can then select one of firstfemoral prosthesis 120 and second femoral prosthesis 140 forimplantation in the knee joint based on first visual indicators 54A andsecond visual indicators 58A of provisional femoral component 20A.

Referring to FIG. 5, in another embodiment, because provisional femoralcomponent 20A can be an ambidextrous provisional femoral component, aswill be discussed in more detail below, if distal femur F is a rightknee, the surgeon can reference anterior right lateral portion 86A ofprovisional femoral component 20A with anterior lateral edge 175 ofdistal femur F to visually lateralize provisional femoral component 20Awith a right distal femur F.

In another embodiment, the present disclosure provides a provisionalfemoral component including a patellofemoral flange having two sulci anda central ridge between the two sulci. Accordingly, the provisionalfemoral component of the present disclosure is capable of beingpositioned on a resected distal femur surface of both a right and leftknee. Although in the exemplary embodiment of FIGS. 1-6, provisionalfemoral component 20A is illustrated as a bicondylar provisional femoralcomponent, i.e., a provisional femoral component having a first condyleand a second condyle, it is contemplated that other provisional femoralcomponents may be utilized in accordance with the present disclosuresuch as a patellofemoral flange femoral component for a patellofemoraljoint system. For example, provisional femoral component 20A could bepart of a patellofemoral joint system in accordance with thepatellofemoral joint system described in the “Zimmer® Gender Solutions™Patello-Femoral Joint (PFJ) System, Surgical Technique” brochure,copyright 2008, 2009, published by Zimmer, Inc., the entire disclosureof which is hereby expressly incorporated by reference herein.

Referring to FIGS. 2 and 4, patellofemoral flange 34A of provisionalfemoral component 20A generally includes non-articulating surface orbone contacting surface 72A and opposing articulating surface 74A.Referring to FIG. 4, in one embodiment, bone contacting surface 72A isplanar. Bone contacting surface 72A is adapted to affix patellofemoralflange 34A to a distal portion of a femur such as distal femur F shownin FIG. 5. Articulating surface 74A of patellofemoral flange 34Aincludes first sulcus 76A formed in patellofemoral flange 34A, secondsulcus 78A formed in patellofemoral flange 34A, and raised mid-line orcentral ridge 80A disposed between first sulcus 76A and second sulcus78A. Patellofemoral flange 34A also includes first anterior flange 82Aand second anterior flange 84A extending along respective medial/lateralperipheries of patellofemoral flange 34A. Referring to FIG. 4, firstanterior flange 82A and second anterior flange 84A each have an anteriorflange thickness, and central ridge 80A has a central ridge thickness.In one embodiment, the anterior flange thickness of first anteriorflange 82A and second anterior flange 84A is greater than the centralridge thickness of central ridge 80A. First sulcus 76A and second sulcus78A are each disposed between first anterior flange 82A and secondanterior flange 84A. In one embodiment, patellofemoral flange 34A has asagittal plane of symmetry and central ridge 80A of patellofemoralflange 34A is disposed along the sagittal plane of symmetry.

For purposes of this disclosure, patellofemoral flange 34A is defined asa flange sized to fit on a distal femur and which articulates with thepatella of a knee joint during normal articulation of the knee jointthrough a normal range of motion. For example, articulating surface 74Aof patellofemoral flange 34A is sized and shaped for articulating with anatural or prosthetic patella during normal articulation of a knee jointthrough a normal range of motion. First sulcus 76A and second sulcus 78Aare each defined as a sulcus or patellofemoral groove of patellofemoralflange 34A sized and shaped to provide a groove to receive a natural orprosthetic patella of a knee joint during normal articulation of theknee joint through a normal range of motion.

In one embodiment, as illustrated in FIG. 4, patellofemoral flange 34Ais formed by conceptually merging right lateral portion 86A of a rightfemoral component and left lateral portion 85A of a left femoralcomponent to form first sulcus 76A, second sulcus 78A, and central ridge80A disposed between first sulcus 76A and second sulcus 78A. Referringto FIG. 4, dashed lines illustrate medial portion 87A of a left femoralcomponent and medial portion 88A of a right femoral component 88A. Firstsulcus 76A is formed in patellofemoral flange 34A between central ridge80A and first anterior flange 82A and second sulcus 78A is formed inpatellofemoral flange 34A between second anterior flange 84A and centralridge 80A.

Referring to FIGS. 2 and 4, the use of patellofemoral flange 34A duringtrialing of the knee joint to determine a proper size of apatellofemoral flange prosthesis will now be described. Oncepatellofemoral flange 34A is properly positioned adjacent anterior cut164 (FIG. 5) of resected distal femur surface 160 (FIG. 5), a surgeoncan perform range of motion testing of the knee joint and trackarticulation of the patella with patellofemoral flange 34A. Centralridge 80 provides tactile feedback to the surgeon to indicate when thepatella is dislocating medially. In this manner, when usingpatellofemoral flange 34A with a left distal femur of a left knee joint,first anterior flange 82A of left lateral portion 85A simulates alateral aspect of patellofemoral flange 34A and central ridge 80Asimulates a medial aspect of patellofemoral flange 34A. In this manner,the surgeon can track the patella through range of motion testing andreceive feedback when the patella is dislocating medially, i.e., whenthe patella rides over central ridge 80A and out of first sulcus 76A. Inthis embodiment, second anterior flange 84A simulates a medial aspect ofpatellofemoral flange 34A.

Patellofemoral flange 34A can also be used on a right distal femur of aright knee joint. For example, with patellofemoral flange 34A positionedadjacent a right distal femur of a right knee joint, second anteriorflange 84A of right lateral portion 86A simulates a lateral aspect ofpatellofemoral flange 34A and central ridge 80A simulates a medialaspect of patellofemoral flange 34A. In this manner, the surgeon cantrack the patella through range of motion testing and receive feedbackwhen the patella is dislocating medially, i.e., when the patella ridesover central ridge 80A and out of second sulcus 78A. In this embodiment,first anterior flange 82A simulates a medial aspect of patellofemoralflange 34A.

Patellofemoral flange 34A of the present disclosure may be used with apatellofemoral system designed to provide a partial knee replacement inwhich only the patellofemoral compartment of the distal femur receives aprosthesis. In another embodiment, patellofemoral flange 34A of thepresent disclosure can be used with provisional femoral component 20A asillustrated in FIGS. 1-6 for use in a total knee arthroplasty procedure.In such an embodiment, a provisional femoral component is provided whichcan be positioned on the distal femur of both a right and left kneejoint, and which includes first visual indicators 54A spaced alongprovisional peripheral wall 53A to visually represent a first profile ofa first femoral prosthesis and second visual indicators 58A spaced alongprovisional peripheral wall 53A to visually represent a second profileof a second femoral prosthesis as discussed in more detail above.

Referring to FIGS. 8-12, provisional femoral components 20B, 20C eachinclude patellofemoral flange 34B, 34C having one sulcus 36B, 36C. Inalternative embodiments, provisional femoral components 20B, 20C caneach include patellofemoral flanges 34B, 34C having two sulci asdescribed above with respect to patellofemoral flange 34A of theembodiments of FIGS. 1-6. In such embodiments, provisional femoralcomponents 20B, 20C could each be used on both a right and left distalfemur of both a right and left knee joint.

Referring to FIGS. 6, 8, and 11, provisional femoral components 20A,20B, 20C of the present disclosure can also be used as a femoral cutguide for preparing a distal femur to receive a prosthetic femoralcomponent of a knee implant, the prosthetic femoral component comprisinga posterior stabilized prosthesis including a central box. Particularly,provisional femoral component 20A, 20B, 20C may be used to remove bonefrom distal femur F (FIGS. 5 and 7) to accommodate a box projection of aposterior stabilized prosthetic femoral component. In one embodiment,the box projection can include medial and lateral sidewalls. In someembodiments, the box projection can also include an anterior sidewall.

Referring to FIGS. 6 and 9, provisional femoral components 20A, 20Brespectively include guide slot 90A, 90B and opening 94A, 94B having apair of side walls 96A, 96B. Referring to FIGS. 6 and 11, provisionalfemoral components 20A, 20C each include apertures 92A that are sized tobe used for preparing holes for the femoral lugs or pegs of the femoralimplant. Apertures 92A can also be sized to receive bone screws and/orpins for anchoring provisional femoral components 20A, 20C to apatient's distal femur F (FIGS. 5 and 7). In one embodiment, provisionalfemoral component 20B may also include apertures similar to apertures92A, 92C. With provisional femoral components 20A, 20B positioned on aresected distal femur surface, the knee joint can be articulated througha full range of motion testing. Provisional femoral components 20A, 20B,20C of the present disclosure may be used as a femoral cut guide inaccordance with the femoral cut guide described in U.S. patentapplication Ser. No. 12/844,495, filed Jul. 27, 2010, entitled “FemoralCut Guide,” the entire disclosure of which is hereby expresslyincorporated herein by reference.

In one embodiment, referring to FIGS. 11 and 12, provisional femoralcomponent 20C may include receiving slot 98C and keyway or track 100formed in each side wall 96C. In such an embodiment, modular insertcomponent 102C may be removably attached to provisional femoralcomponent 20C in opening 94C between side walls 96C. When assembled, asurgeon may verify proper articulation of provisional femoral component20C against a patient's adjacent patella and tibia. Modular insertcomponent 102C includes lower patellofemoral track 104C, locking tabs106C, key or insertion rails 108C, and modular insert component cutouts110C. To secure modular insert component 102C to provisional femoralcomponent 20C, locking tabs 106C and insertion rails 108C arerespectively positioned within receiving slots 98C and tracks 100C ofprovisional femoral component 20C. In one embodiment, modular insertcomponent 102C provides the most distal aspect, i.e., lowerpatellofemoral track 104C, of the patella track of provisional femoralcomponent 20C. In such an embodiment, with modular insert component 102Csecured to provisional femoral component 20C and provisional femoralcomponent 20C positioned on a resected distal femur surface, the kneejoint can be articulated through a full range of motion testing. Withoutmodular insert component 102 secured to provisional femoral component20C, the knee joint can still be articulated through partial range ofmotion testing. Modular insert component cutouts 110C allow a femoralinserter/extractor surgical instrument to engage modular insertcomponent 102C for easy insertion and removal of modular insertcomponent 102C. In one embodiment, locking tabs 106C can be removed fromthe anterior portion of modular insert component 102C. In such anembodiment, locking tabs 106C can be a part of insertion rails 108C andfunction to secure modular insert component 102C to provisional femoralcomponent 20C.

While this disclosure has been described as having exemplary designs,the present disclosure can be further modified within the spirit andscope of this disclosure. This application is therefore intended tocover any variations, uses, or adaptations of the disclosure using itsgeneral principles. Further, this application is intended to cover suchdepartures from the present disclosure as come within known or customarypractice in the art to which this disclosure pertains and which fallwithin the limits of the appended claims.

What is claimed is:
 1. A femoral prosthesis system, comprising: a firstfemoral prosthesis, comprising: a first condyle, said first condyledefining a first articulating surface and an opposing first bonecontacting surface; and a first peripheral wall spanning said firstarticulating surface and said first bone contacting surface, said firstperipheral wall defining a first profile; a second femoral prosthesis,comprising: a second condyle, said second condyle defining a secondarticulating surface and an opposing second bone contacting surface; anda second peripheral wall spanning said second articulating surface andsaid second bone contacting surface, said second peripheral walldefining a second profile, wherein said second profile is different thansaid first profile; a provisional femoral component, comprising: aprovisional condyle, said provisional condyle defining a provisionalarticulating surface and an opposing provisional bone contactingsurface; a provisional peripheral wall spanning said provisionalarticulating surface and said provisional bone contacting surface; andat least one first visual indicator and at least one second visualindicator spaced along said provisional peripheral wall, said at leastone first visual indicator visually representing said first profile ofsaid first femoral prosthesis, and said at least one second visualindicator visually representing said second profile of said secondfemoral prosthesis.